Pier Luigi Lopalco ECDC, Unit for Scientific Advice

1. The importance of TBE in the perspective of the ECDC Pier Luigi Lopalco ECDC, Unit for Scientific Advice Jan 29-30, 2009 Vienna

2. What is the role of ECDC? Identify, assess & communicate current & emerging health threats to human health from communicable diseases (ECDC Founding Regulation (851/2004), Article 3) • EU level disease surveillance • Scientific opinions and studies • Early Warning System and response • Technical assistance and training • Epidemic intelligence • Communication to scientific community • Communication to the public

3. Director Zsuzsanna Jakab How is ECDC organised? • Cabinet/Office of the Director • Strategic Management • Governance • External Relations, • Partnership • Country Relations Chief Scientist Johan Giesecke Internal Auditor Stefan Sundbom Surveillance Unit Andrea Ammon Scientific Advice Unit Johan Giesecke Preparedness and Response Unit Denis Coulombier Health Communication Unit Karl Ekdahl Administrative Services Unit Jef Maes H O R I Z O N T A L P R O G R A M M E S Scientific Communication Data Management and General Surveillance Epidemic Intelligence and Emergency Operations Centre Microbiology Coordinator Legal and Procurement Disease Specific Surveillance Evidence Base for Prevention and Control Outbreak, Preparedness and Support Public Communication and Media Human Resources Scientific and Technical Advice Knowledge Services Epidemiological Training Web Services Finance and Accounting ICT Future Threats and Determinants Respiratory Tract Infections (Influenza – Tuberculosis) STI including HIV and Blood-Borne Viruses Vaccine Preventable Diseases Antimicrobial Resistance and Healthcare-Associated Infections Food and Water-Borne Diseases and Zoonoses Emerging and Vector-Borne Diseases Missions, Meetings and Logistics

4. What is Decision 2119/98 ? • Decision of the European Parliament and the Council setting up a network for the epidemiological surveillance and control of communicable diseases in the Community • On 22 December 1999 the EU Commission deliver a Decision on the communicable diseases to be progressively covered by the Community network (2000/96/EC)

5. Basic Surveillance Network Divine-net vCJD EUCAST EISS DIP-net EARSS Enter-Net EUVAC Measles EWGLINet EU-IBIS ENIVD ESAC ESSTI HIV/AIDS Tuberculosis IPSE Dedicated Surveillance networks funded through Public Health programmes with a wide variety of data flows and databases

6. Planned Solution: One-Stop-Shop MS MSs Data users MS National institutes MS Disease experts MS General public MS AF members MS TESSy Data access Data upload and access MB members MS The European Surveillance System WHO MS EMCDDA MS EFSA MS Others MS MS … MS

7. TBE is NOT included in the list of diseases to be reported at EU level • Criteria: • Diseases that cause, or have the potential to cause, significant morbidity and/or mortality across the Community […] • Diseases where the exchange of information may provide early warning of threats to public health. • Rare and serious diseases […] where the pooling of data would allow hypothesis generation from a wider knowledge base. • Diseases for which effective preventive measures are available with a protective health gain. • Diseases for which a comparison by Member States would contribute to the evaluation of national and Community programmes.

8. TBE surveillance in EU member states Donoso Mantke O et al. Eurosurveillance 2008; 13

9. Scientific advice Five strategies: • Public health research catalyst • Promote, initiate and coordinate scientific studies • Produce guidelines, risk assessments, scientific advice • Prime source of scientific advice on infectious diseases • Microbiological laboratory support

10. Increased focus on delivery of scientific publications and advice

11. Examples in the vaccines field • Sudden deaths and influenza vaccinations in Israel – ECDC Interim Risk Assessment, October 2006 • Infant and children seasonal immunisation against influenza on a routine basis during inter-pandemic period, January 2007 • Use of pneumococcal polysaccharide vaccine for subjects over 65 years of age during an inter-pandemic period, January 2007 • Expert Advisory Groups on Human H5N1 Vaccines, Public Health and Operational Questions Stockholm, August 2007 • Guidance for the introduction of HPV vaccines in EU countries, January 2008 • Technical guidance on DTP childhood vaccination, 2009

12. Are there knowledge gaps related to TBE vaccines? • Duration of immunity? • Need for boosters? • Breakthrough infections? • Childhood vaccination?

13. TBE epidemiology in the EU Süss J, Eurosurveillance, 2008; 13

14. The VENICE ProjectVaccine European New Integrated Collaboration Effort • Start in 2006 after a contract with the Commission • VENICE-2 in 2009 after a contract with the ECDC • Priority activities in the first half 2009: • Seasonal influenza vaccination coverage • Extended survey on TBE assessment and TBE vaccination policies in EU countries

15. Issues potentially covered by the coming VENICE survey • Assess the impact of different vaccination strategies on the TBE burden in the EU • Knowledge gaps at national and EU level to be covered in the near future in terms of surveillance, scientific advice, communication to the public

16. Conclusions • The ECDC will start several activities on TBE • The VENICE network is going to perform a EU-wide survey on TBE assessment and vaccination policies • The ECDC has no legal role in driving national policies • Scientific advice and risk assessment will guide the national authorities in implementing good practices and harmonising behaviours throughout the EU

17. Thank You! www.ecdc.europa.eu